BACKGROUND: The present study evaluated the steroid-sparing effect of subcutaneous SQ-standardized specific immunotherapy (SIT) in moderate and severe house dust mite (HDM) allergic asthmatics. METHODS:Fifty-four adult asthmatics allergic to HDM requiring at least inhaledcorticosteroids (ICS) doses equivalent to 500 microg fluticasone propionate daily were randomized to subcutaneous SIT or placebo injections for a period of 3 years. The minimum required ICS dose, 4 week diary of asthma symptom score, use of rescue medication, peak expiratory flow (PEF) measurements and visual analog scale for asthma symptoms were assessed before start of treatment and after 1, 2 and 3 years of treatment. RESULTS: In patients with moderate and severe asthma, the reduction in ICS was statistical significant after 2 years of treatment (P = 0.03) but not after 3 years. The median reductions were 82% and 42% after the third year for active and placebo respectively. In patients with moderate persistent asthma the reduction was statistical significant larger for those treated with SIT compared with placebo after year 2 and year 3. The median reductions after 3 years were 90% for SIT and 42% for placebo (P = 0.04). Despite significant steroid reduction, there was no difference in asthma assessments between the two groups. No serious reactions related to SIT injections were seen. CONCLUSION: This study shows that SIT with a SQ-standardized HDM extract is safe. An ICS sparing effect was evident in patients with moderate persistent asthma.
RCT Entities:
BACKGROUND: The present study evaluated the steroid-sparing effect of subcutaneous SQ-standardized specific immunotherapy (SIT) in moderate and severe house dust mite (HDM) allergic asthmatics. METHODS: Fifty-four adult asthmatics allergic to HDM requiring at least inhaled corticosteroids (ICS) doses equivalent to 500 microg fluticasone propionate daily were randomized to subcutaneous SIT or placebo injections for a period of 3 years. The minimum required ICS dose, 4 week diary of asthma symptom score, use of rescue medication, peak expiratory flow (PEF) measurements and visual analog scale for asthma symptoms were assessed before start of treatment and after 1, 2 and 3 years of treatment. RESULTS: In patients with moderate and severe asthma, the reduction in ICS was statistical significant after 2 years of treatment (P = 0.03) but not after 3 years. The median reductions were 82% and 42% after the third year for active and placebo respectively. In patients with moderate persistent asthma the reduction was statistical significant larger for those treated with SIT compared with placebo after year 2 and year 3. The median reductions after 3 years were 90% for SIT and 42% for placebo (P = 0.04). Despite significant steroid reduction, there was no difference in asthma assessments between the two groups. No serious reactions related to SIT injections were seen. CONCLUSION: This study shows that SIT with a SQ-standardized HDM extract is safe. An ICS sparing effect was evident in patients with moderate persistent asthma.
Authors: G Walter Canonica; Jean Bousquet; Thomas Casale; Richard F Lockey; Carlos E Baena-Cagnani; Ruby Pawankar; Paul C Potter; Philippe J Bousquet; Linda S Cox; Stephen R Durham; Harold S Nelson; Giovanni Passalacqua; Dermot P Ryan; Jan L Brozek; Enrico Compalati; Ronald Dahl; Luis Delgado; Roy Gerth van Wijk; Richard G Gower; Dennis K Ledford; Nelson Rosario Filho; Erkka J Valovirta; Osman M Yusuf; Torsten Zuberbier Journal: World Allergy Organ J Date: 2009-11-19 Impact factor: 4.084
Authors: Ann-Kathrin Richter; Ludger Klimek; Hans F Merk; Norbert Mülleneisen; Harald Renz; Wolfgang Wehrmann; Thomas Werfel; Eckard Hamelmann; Uwe Siebert; Gaby Sroczynski; Jürgen Wasem; Janine Biermann-Stallwitz Journal: Eur J Health Econ Date: 2018-03-24
Authors: Michelle M Cloutier; Alan P Baptist; Kathryn V Blake; Edward G Brooks; Tyra Bryant-Stephens; Emily DiMango; Anne E Dixon; Kurtis S Elward; Tina Hartert; Jerry A Krishnan; Robert F Lemanske; Daniel R Ouellette; Wilson D Pace; Michael Schatz; Neil S Skolnik; James W Stout; Stephen J Teach; Craig A Umscheid; Colin G Walsh Journal: J Allergy Clin Immunol Date: 2020-12 Impact factor: 10.793